Managing Cyclic Depression

Most people who don't have clinical depression have no idea how totally disabling it can be. It's easy to say "I'm depressed" when what one means is "I'm sad". They're not the same thing -- ask anyone who has ever been truly depressed. Being sad makes you want to cry. Being depressed sucks out your soul, makes you apathetic, makes you want to die, even when you can look at your life objectively and realize that there is no legitimate reason for feeling that awful. I have looked at my doc when I was off my meds because I was pregnant and said "I just want to die and I know there is nothing wrong with my life. But give me my drugs back and in two weeks I will be fine." And I was. That is depression, not sadness.

I have struggled with clinical depression since my childhood, as my parents did before me, and have taken medication for most of the past twenty years. It takes a cocktail of meds to keep me stable and, for the most part, high-functioning and even content. I am a testament to big pharma. Better living through chemicals. I accept this.

I have "severe treatment-resistant cyclical clinical depression", which means basically that I have it badly, that most drugs don't work on me and that that is why it takes a cadre of them to keep me stable, and that my depression gets worse in more or less predictable cycles. In my case, I can almost post on my calendar in advance that I will have a hard time in March-April and around November, and then I'll pull out of it again to some extent. Various psychs have posited the theory that this is SAD (Seasonal Affective Disorder), but that doesn't make sense, since SAD is linked to sunlight deprivation. If it were SAD, I would be, well, sad from October or November when it gets grey UNTIL March or April when it gets sunny again. I would not be fine from December through February while it's grey. Nope: it's cyclical, and those months are my two downward cycles, more or less.

Does anyone know why? Not that I know of, least of all me. I could make up answers, but that's what I'd be doing. I've had these cycles since childhood.

Nobody I've ever met really understands cyclical depression. All they can do is give me drugs to keep me stable and hope those drugs get me through the two worst periods of the year in relative stability, knowing I will still have a bad time of it for a while. The rest is up to me, and since I've had enough practice, I should be good at it, right?

It does actually help that I recognize the onset now and I know what is happening. I know that the SX's will pass in time, and even about when. That puts light at the end of the tunnel, although the end point may seem very far away, and that is hard. It's even hard knowing I'm coming up on one of them. Does that cause it? I don't think so. I got away without this year's March-April cycle completely, but that was unusual.

What can you do when I'm down? If you are another depressive, by all means share that with me if you're willing to, along with your best wishes and coping mechanisms. I will be warmed to know that someone understands how awful it is.

But realize that you don't HAVE to know how I feel to comfort me. On behalf of all truly depressed people everywhere, I beg those of you who have never experienced this not to believe you know "just how it is" because you were really down in the dumps once. I'm sure you felt bad; I'm sorry. But you still don't have a clue. It does NOT help to tell me just to "cheer up and everything will be fine". This makes me unreasonably angry: why would anyone assume that I'm enjoying this and wouldn't change it if I could? I LIKE huddling in my bed all day with suicidal thoughts, dragging myself out just long enough to drive my kids to school and make sure they're fed? Um ... maybe not? Maybe I'm actually doing the best I can just to keep going at all under the circumstances?

If you want to be supportive of me even though you don't understand why I'm like this, don't assume you could handle this better than I am. I'm not exaggerating how bad things are in MY world: that's the nature of the illness. That's my reality. Instead, bring us a casserole so I don't have to cook dinner, offer to bring my kids home from school one day or take them after school one day, pick up milk and bread at the grocery store when I can't make myself get dressed, tell me you love me (that always helps, even if I can't express that it does). But please, tell me you know how I feel only if it's true.

And please, don't judge me. I didn't choose this. I'm not crazy, I'm depressed: there is a difference. This is a disease with an underlying genetic basis which I got from both parents. Unlike them, I seek professional help and I take my meds. It is not a moral issue, and I would not be well if I'd just "have a more positive attitude" or "more self-control". If you wouldn't criticize a diabetic, don't criticize me. I'm doing my best.

To all of my brothers and sisters out there suffering silently, with or without meds, all year, keep fighting. One day they will unlock this, and we will be free.

Have a nice day?